Understanding Violent Behavior in Early Psychosis Through the Fluid Vulnerability Theory: an Exploratory Qualitative...

Area of Science:

• Psychiatry
• Psychology
• Public Health

Background:

• Young adults with early psychosis exhibit elevated risks for violent behavior compared to the general population.
• Similarities exist between the contexts of violent and suicidal behaviors, suggesting shared underlying mechanisms.
• Early intervention services (EIS) offer coordinated specialty care for psychosis but require refined strategies for managing violence risk.

Purpose of the Study:

• To investigate the drivers and consequences of violent ideation and behavior in young adults with early psychosis.
• To adapt suicide prevention frameworks, specifically the "suicide narrative" approach, for understanding and addressing violence in this population.
• To explore the feasibility and utility of eliciting "violence narratives" within early intervention settings.

Main Methods:

• Qualitative study involving 6 participants and 12 staff members from OnTrackNY early intervention services.
• Interviews utilized a "violence narrative" format, adapted from the Stanley-Brown Safety Planning Intervention, to explore specific episodes of violent ideation or behavior.
• Participant and staff responses were analyzed and categorized using Fluid Vulnerability Theory (FVT).

Main Results:

• Eliciting violence narratives was feasible and provided valuable insights for young adults with early psychosis and their treatment teams.
• Key risk factors associated with violent ideation or behavior were identified within the Fluid Vulnerability Theory domains.
• The process facilitated a deeper, more therapeutic understanding of violence for both participants and staff.

Conclusions:

• Violence narratives are a viable tool for understanding and intervening in violent ideation and behavior among young adults with early psychosis.
• Identifying specific risk factors through these narratives can inform the development of targeted interventions.
• Further research is recommended to integrate violence narrative approaches into routine early psychosis treatment.